Department of Internal Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
Department of Statistics, University of Michigan, Ann Arbor, Michigan, USA.
Liver Int. 2022 Jul;42(7):1557-1561. doi: 10.1111/liv.15277. Epub 2022 May 11.
Alcohol-related liver disease (ALD) is the leading indication for liver transplantation in the United States, but disparities for women with ALD exist. We sought to characterize trends in ALD hospitalizations and mortality among women. Using the National Inpatient Sample, we evaluated ALD and non-ALD discharges from 2003 to 2017. Multivariable logistic regression was used to evaluate mortality. ALD increased more rapidly among women, with alcohol hepatitis (AH) rising the most. When stratified by age and sex, changes in alcohol-related cirrhosis (AC) and AH were greater in women in nearly all age groups. Similar increases were present when stratified by race, notably for Native American and Asian women. AH mortality increased in women in almost all age groups. While ALD remains predominantly male, discharges and mortality have disproportionately increased among women, particularly in young women and Native Americans. These findings shed light on populations in need of intensive public health interventions.
酒精相关性肝病 (ALD) 是美国肝移植的主要指征,但女性 ALD 存在差异。我们旨在描述女性 ALD 住院和死亡率的趋势。我们使用国家住院患者样本,评估了 2003 年至 2017 年期间的 ALD 和非 ALD 出院情况。多变量逻辑回归用于评估死亡率。ALD 在女性中的增长速度更快,其中酒精性肝炎 (AH) 的增长幅度最大。按年龄和性别分层时,几乎所有年龄段的女性的酒精性肝硬化 (AC) 和 AH 变化更大。按种族分层时也存在类似的增加,尤其是在美洲原住民和亚裔女性中。AH 死亡率在几乎所有年龄段的女性中都有所增加。尽管 ALD 主要发生在男性中,但女性的出院和死亡率不成比例地增加,尤其是在年轻女性和美洲原住民中。这些发现揭示了需要强化公共卫生干预的人群。